Therapeutic effect of arthroscopic segmental labral resection combined with microfracture at the rim of the acetabulum for irreparable labral lesions

Di-san junyi daxue xuebao

SU Tiao¹  LI Jing¹  CHEN Guangxing¹ 

[1] Center for Joint Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China ;

关键词: hip arthroscopy;    labral lesion;    irreparable;    labral debridement;    microfracture;    marrow stimulation;   

DOI  :  10.16016/j.1000-5404.201812129

来源: DOAJ

【 摘 要 】

Objective To explore the clinical outcomes and the possibility of labrum regrowth in patients undergoing arthroscopic segmental labral resection combined with microfracture at the rim of the acetabulum for irreparable labral lesions. Methods From February, 2014 to August, 2016, 17 patients (including 9 male and 8 female patients with a mean age of 45.6 years, range 23-61 years) with irreparable labral injury involving 22 hips underwent arthroscopic labral resection with or without microfracture at the rim of the acetabulum at our center (microfracture group and resection group, respectively). Single radial hip magnetic resonance imaging (MRI) at least 6 months postoperatively was performed to observe the homogeneous low signal in the involved area, and fluoroscopic image of the involved hip under distraction were obtained to evaluate the recovery. Harris Hip Score (HHS), Hip Outcome Score-Activity of Daily Life (HOS-ADL) and Visual Analogue Scale (VAS) score were assessed both preoperatively and postoperatively to evaluate the functional outcome of the patients. Results The patients were followed up for 35.5±10.6 months (range, 26-56 months) after the surgeries. At the last follow up, single radial hip MRI revealed homogeneous low signal intensity in the area where the labrum was deemed irreparable and resected followed by microfracture of the remaining acetabular rim in all the patients in the microfracture group; in the resection group, no homogeneous low signal intensity were detected in the defects of the acetabular rim. Obvious vacuum effect was observed in all the fluoroscopic views in patients in the microfracture group, but not in the resection group. Functional assessment of the hip joint showed significant improvement of postoperative HHS, HOS-ADL and VAS scored in both groups (P < 0.05) without significant differences between the 2 group. Conclusion Arthroscopic segmental labral resection with or without microfracture at the rim of acetabulum achieves similar short-term functional outcomes. Marrow stimulation by microfracture recreates a fibrocartilage-like tissue at the labrum defects of the acetabular rim and restores the hydraulic seal effect of the labrum, which helps to preserve the long-term hip function. This surgical approach provides a new treatment option for irreparable labral lesions.

【 授权许可】

Unknown